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Biomedical subjects

S Jain

Publications and source records attributed to S Jain.

At least 289 records · Page 16Linked to original sources

Visceral leishmaniasis masquerading as tuberculosis in a patient with AIDS.

We report a case of visceral leishmaniasis presenting as significant lymphadenopathy in a patient with acquired immune deficiency syndrome. The lymphadenopathy was initially suspected to be tubercular in nature on pathological examination. This report highlights the increasing incidence of acquired immune deficiency syndrome and Leishmania co-infection in India, and the importance of demonstrating tubercle bacilli on culture before suggesting a diagnosis of tuberculosis.

AIDS-Related Opportunistic Infections↗

Molecular cloning and sequence analysis of the cDNA encoding beta-lactoglobulin in Bubalus bubalis.

The cDNA for bubaline beta-lactoglobulin (beta lg) has been cloned through RT-PCR approach and sequenced. Sequence data showed a single open reading frame coding for a protein of 180 amino acids with a signal sequence of 18 amino acid residues. Comparison with other ruminant beta lg sequences revealed a high homology indicating the protein to be conserved through evolution. The degree of homology, at amino acid level, is 96.1%, 95.6%, 93.9% and 63.7% with goat, sheep, cow and pig, respectively.

Amino Acid Sequence↗

Profile of cardiac tamponade in the medical emergency ward of a North Indian hospital.

OBJECTIVE: To determine the profile of patients presenting to the medical emergency ward with cardiac tamponade. DESIGN: Retrospective observational study. SETTING: Tertiary care hospital in North India. PATIENTS: Thirty patients (19 men and 11 women) presenting to the medical emergency ward with cardiac tamponade from March 1, 1995 to March 31, 1997. MAIN RESULTS: The mean age was 36.5+/-7.6 years for the men and 34+/-12.4 years for the women. Breathlessness, fever, cough, chest pain and easy fatigability were present in 97%, 90%, 70%, 57% and 37% of patients, respectively. Etiologically, tuberculosis accounted for 60%, malignant disease for 33% and hypothyroidism for 7% of cases of cardiac tamponade. Echocardiographically guided pericardiocentesis was carried out in all patients without any complications. Six patients underwent catheter pericardial drainage and, of these, four required pericardiostomy. CONCLUSIONS: Tuberculosis ranked as the most common cause of cardiac tamponade in Northern India, followed by malignancy. Therapeutically, echocardiographically guided pericardiocentesis for cardiac tamponade is a safe and effective procedure. For those with recurrent pericardial effusions, catheter pericardial drainage is a safe option until the underlying cause can be treated or surgery planned.

Adult↗

Cytomorphological spectrum of cysticercosis--a review of 132 cases.

A retrospective analysis of fine needle aspirates of 132 cases of cysticercosis presenting as palpable nodule is presented. In 98 cases, larval parts, detached hooklets and scolex established the diagnosis; in another 34 cases, the background inflammatory pattern was helpful in suggesting the diagnosis of a parastic lesion.

Adolescent↗

Trauma scoring in a developing country.

AIM OF STUDY: The aim of the study was to evaluate the efficacy of trauma scoring systems in a developing country. METHOD: Trauma Score (TS) and Trauma and Injury Severity Score (TRISS) were used to predict the survival of 462 trauma patients during the period January 1996 to July 1996. RESULTS: TS had a sensitivity of 53.9% and a specificity of 98.8% whereas TRISS had a sensitivity of 46% and a specificity of 98.7%. Significant differences in mortality were observed compared with the baseline Major Trauma Outcome Study (MTOS) norms (Z = 4.17, p < 0.001). CONCLUSION: Present injury severity instruments using MTOS coefficients do not accurately predict survival of trauma patients in a developing country, thus highlighting the need for developing new coefficients for trauma scoring in these countries.

Developing Countries↗

Outbreak of cholera in arid zone of Bikaner.

Bikaner being an arid zone was more or less unaffected by cholera until 1994 when an outbreak of clinical cholera occurred. We isolated 64 Vibrio cholerae strains out of 475 stool samples received (isolation rate 13.47%). All the Vibrio strains belonged to biotype El Tor serotype Ogawa. Low isolation rate was probably related to the poor transportation and medical facilities available at remote areas and indiscriminate and irrational use of antibiotics. The antimicrobial susceptibility testing of the isolates has not shown significant resistance against commonly used antimicrobials.

Cholera↗

Hypertension and the kidneys--inter-relationship and therapeutic approach.

Over the last decade, a great body of evidence has pointed towards the role of kidneys in the genesis and maintenance of a hypertensive state. There exists a relationship between a rise in the blood pressure and a proportionate increase in the urinary excretion of sodium and water called the pressure-natriuresis curve. Chronic renal diseases are the most common causes of secondary hypertension accounting for 2-5% of all cases of secondary hypertension. The prevalence rate of renovascular hypertension based upon referral patterns range from 0.2% to 10% of hypertensive population. The data provided by the International Registries on end-stage renal disease have suggested that essential hypertension is an important cause of progressive renal damage. The pathological lesion observed in malignant hypertension is fibrinoid necrosis of the small arteries and arterioles. Amongst the armamentarium of antihypertensive drugs calcium channel antagonists and the angiotensin converting enzyme inhibitors have a role in limiting glomerular hypertension. The best modality to prevent and treat renal dysfunction in the presence of hypertension is an adequate and effective control of high blood pressure.

Angiotensin-Converting Enzyme Inhibitors↗

Reproductive tract infections among rural women in Meerut.

The present study was done among 500 women of reproductive age group. Study revealed overall prevalence rate of RTI of 44.8%. Excessive vaginal discharge was the most common presenting symptom (42.0%). Inspite of such an high prevalence of reproductive tract infections, only 22.8% of the women sought treatment for their problem. The study suggests to improve the awareness about RTI and its treatment facility among women and also recommends to develop a strategy to train and reorient the health personnel.

Adolescent↗

Myoglobinuria and transient acute renal failure in a patient revealing hypothyroidism.

Muscle involvement in hypothyroidism commonly manifests as fatigue, myalgias, stiffness and slowed reflexes. We report a case of transient acute renal failure related to rhabdomyolysis and myoglobinuria in a 40 year old man that revealed the diagnosis of hypothyroidism with myopathy. The patient had proximal muscle weakness and tenderness, markedly raised muscle enzymes and deranged renal functions that normalised with thyroid replacement therapy. Hypothyroidism, though rare, should be considered a definite and authentic cause of rhabdomyolysis.

Acute Kidney Injury↗

Epilepsy surgery in India: All India Institute of Medical Sciences experience.

OBJECTIVES: Surgical treatment of epilepsy should be considered an important alternative to medical therapy. The identification of a suitable candidate, pre-operative evaluation requires a multidisciplinary team. The specific diagnostic studies required depend on the operative strategy and objective of surgical treatment. METHODS: In twenty patients with medically intractable epilepsy, who had clinical evaluation, electroencephalography (EEG), video-EEG monitoring using scalp electrodes, high resolution magnetic resonance imaging (MRI), neuropsychology, single photon emission computed tomography (SPECT) was done to localise the seizure focus. If the investigations were concordant resective surgery was performed. In case of frequent falls, atonic and tonic seizures, with generalised/multifocal discharges on EEG, a callostomy was done. Surgical outcome was assessed using Engel's 4 point scale. RESULTS: In 18 patients the seizure focus was localised, 13 had temporal lobectomy, five extra-temporal resection, and two had callosotomy. Fifteen patients had a follow-up of more than eight months, mean 20.5 (range 8-35 months), 13 had outcome I (seizure free), two had outcome II (occasional seizures), one-outcome III. Three were lost to follow-up and one patient died. There were no major post-operative complications. CONCLUSIONS: Surgical treatment of epilepsy is a safe, effective mode of therapy. Suitable candidates should be identified early and referred to appropriate centres.

Adolescent↗

Profuse variceal hemorrhage as a presenting feature of pancreatic adenocarcinoma in a young non-icteric patient.

Pancreatic adenocarcinoma can present with a vast spectrum of rare manifestations. It usually occurs after the age of 50 years, the peak incidence being in sixth and seventh decades. We report a previously asymptomatic subject of pancreatic adenocarcinoma who presented for the first time with massive upper gastrointestinal hemorrhage. Endoscopy revealed ruptured esophageal varices which were secondary to tumour-induced thrombosis of the portal vein. Besides the uncommon mode of presentation, the patient was unusual because of his young age. Further, he was non-icteric at the time of presentation and remained so throughout the clinical course despite having a large lesion in the head of the pancreas.

Adenocarcinoma↗

Cloning and expression of the mouse deoxyuridine triphosphate nucleotidohydrolase gene: differs from the rat enzyme in that it lacks nuclear receptor interacting LXXLL motif.

We have previously reported the cloning of rat deoxyuridine triphosphate nucleotidohydrolase (dUTPase) cDNA and demonstrated that the full-length protein as well as the N-terminal 62-amino acid peptide interacts with peroxisome proliferator-activated receptor alpha (PPARalpha). We now report the cloning of mouse dUTPase cDNA and show that it contains a 162-amino acid open reading frame, encoding a protein with a predicted Mr of 17,400 and differs from rat cDNA, which contains additional 43 amino acids at the N-terminal end. Unlike rat dUTPase, mouse dUTPase failed to bind PPARalpha. An evaluation of 205 amino acid containing rat dUTPase cDNA revealed that the N-terminal 43 extra amino acid segment contains an LXXLL signature motif, considered necessary and sufficient for the binding of several cofactors with nuclear receptors, and its absence in murine dUTPase possibly accounts for the differential binding of these enzymes to PPARalpha. In situ hybridization and immunohistochemical studies revealed that, in the adult mouse, dUTPase is expressed at high levels in proliferating cells of colonic mucosa, and of germinal epithelium in testis. At 9.5-day mouse embryonic development, dUTPase expression is predominantly in developing neural epithelium, and hepatic primordium, and in later developmental stages (11.5-, 13.5-, and 15.5-day embryo), the expression began to be localized to the liver, kidney, gut epithelium, thymus, granular layer of the cerebellum, and olfactory epithelium. We also show that the murine dUTPase gene comprises 6 exons and the 5'-flanking region of -1479 to -27, which exhibited high promoter activity, contains a typical TATA box and multiple cis-elements such as Sp-1, AP2, AP3, AP4, Ker1, RREB, and CREB binding sites. These observations suggest the existence of variants of dUTPase, some of which may influence nuclear receptor function during development and differentiation, in addition to catalyzing the hydrolysis of dUTP to dUMP.

Amino Acid Sequence↗

Cytomorphological spectrum of cysticercosis--a review of 132 cases.

A retrospective analysis of fine needle aspirates of 132 cases of cysticercosis presenting as palpable nodule is presented. In 98 cases, larval parts, detached hooklets and scolex established the diagnosis; in another 24 cases, the background inflammatory pattern was helpful in suggesting the diagnosis of a parasitic lesion.

Adolescent↗